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Evidence summaries

Taxane Containing Regimens for Metastatic Breast Cancer

Taxane-containing regimens appear to improve overall survival, time to progression and overall response compared to regimens with no taxane in women with metastatic breast cancer. Level of evidence: "B"

A Cochrane review (abstract , review [Abstract]) included 28 studies involving a total of 6 871 subjects. There was a statistically significant difference in favour of taxane-containing regimens for overall survival, time to progression, and overall response rate T1. The considerable heterogeneity found probably reflects the varying efficacy of the comparator regimens used in the trials. Taxanes were associated with an increased risk of neurotoxicity (RR 4.84, 95% CI 3.18 to 7.35, P < 0.00001, 24 studies) and hair loss (RR 2.37, 95% CI 1.45 to 3.87, P = 0.0006, 11 studies) but less nausea/vomiting compared to non-taxane-containing regimens (RR 0.62, 95% CI 0.46 to 0.83, P = 0.001, 26 studies). For quality of life measures, none of the individual studies reported a difference in overall or any of quality of life subscales between taxane-containing and non-taxane chemotherapy regimens.

See also the breast cancer guideline of American society of oncology 2.

Table 1. Taxane-containing regimens for metastatic breast cancer compared with no taxane

OutcomeRelative effect (95% CI)Participants (studies)
Overall Survival0.93 (0.88 to 0.99)6 008 (23)
Time to Progression0.92 (0.87 to 0.97)5 960 (22)
Time to Treatment Failure0.90 (0.82 to 0.98)1 724 (5)
Overall Response Rate1.20 (1.14 to 1.27)6 999 (29)
Toxicity1.00 (0.63 to 1.57)5 517 (22)

Comment: The quality of evidence is downgraded by inconsistency (variability in results across studies and heterogeneity in studied interventions).

References

  • Ghersi D, Wilcken N, Simes J, Donoghue E. Taxane containing regimens for metastatic breast cancer. Cochrane Database Syst Rev 2005 Apr 18;(2):CD003366 [Assessed as up-to-date: 14 February 2013]. [PubMed]
  • Korde LA, Somerfield MR, Carey LA et al. Neoadjuvant Chemotherapy, Endocrine Therapy, and Targeted Therapy for Breast Cancer: ASCO Guideline. J Clin Oncol 2021;39(13):1485-1505. [PubMed]

Primary/Secondary Keywords